What are the nursing measures for abdominal drainage tube?

The abdominal drainage tube is inserted into the abdominal cavity through a drainage tube, which is also called drainage in medicine. Post-operative care for the abdominal drainage tube is very important. Generally, abdominal drainage tubes are prone to bleeding, so timely care is required. Usually, you should observe the skin surface for ulcers, or observe the smell and color of the liquid, etc., to reduce the pain in the area.

1. Purpose of abdominal drainage

(1) Prevent the accumulation of blood, digestive fluid, exudate, etc. in the abdominal cavity or surgical field to avoid tissue damage, secondary infection, etc.

(2) Remove pus and necrotic tissue from the abdominal cavity to prevent the spread of infection.

(3) Promote the reduction or closure of dead space in the surgical field to ensure good wound healing.

2. Indications for abdominal drainage

(1) Patients whose bleeding is not completely stopped after abdominal surgery and who may continue to bleed or exude.

(2) After the abdominal cavity or abdominal organs are incised for pus or fluid accumulation, drainage is placed to allow the wound space to gradually shrink and heal. Reduce the occurrence of complications.

(3) After debridement of the abdominal wound, there is still residual infection.

(4) After liver, gallbladder, or pancreatic surgery, bile or pancreatic juice leaks and accumulates from the sutures.

(5) After digestive tract anastomosis or repair. Those with digestive juice leakage.

3. Complications of abdominal drainage

(1) Infection: It may be caused by improper selection of drainage tubes, prolonged retention time, or lax aseptic operation during drainage tube care.

(2) Bleeding: It often occurs after surgery, during dressing changes, tube changes, and during infection.

(3) Chronic sinus formation: It is caused by poor drainage, repeated infection, foreign body stimulation, necrotic tissue or dead space, and prolonged placement of drainage material.

(4) Injury: Due to the deep drainage location, unclear anatomical relationship, and insufficient clinical experience, surrounding tissues and organs may be damaged, such as the intestine, liver, bladder, etc.

(5) Drainage tube slippage, blockage, and difficulty in removal: Because the drainage tube is not firmly fixed during surgery, it often slips out when the patient moves. Generally, the tube must be reinserted, otherwise serious consequences may occur. Pus, blood clots, foreign matter, etc. in the lumen may cause drainage tube blockage. If the fixing suture is too tight and the tube is left in for a long time, it may cause difficulty in removal.

(6) Drainage tube compression of the intestine can cause serious complications such as intestinal obstruction, intestinal necrosis, and intestinal perforation.

4. Nursing of abdominal drainage

(1) Properly secure the drainage tube and drainage bag to prevent compression, twisting, or pulling on the drainage tube when the patient changes position, which may cause it to fall out. In addition, it can also avoid or reduce the pain caused by the traction of the drainage tube.

(2) Maintain unobstructed drainage. If the drainage volume suddenly decreases and the patient feels abdominal distension and fever, check whether the drainage tube is blocked or has fallen off.

(3) Pay attention to the color, volume, odor, and presence of residue in the drainage fluid, accurately record the 24-hour drainage volume, and pay attention to changes in the volume and shape of the drainage fluid to determine the development trend of the patient's condition.

(4) Pay attention to observe whether the skin around the drainage tube has redness, swelling, or skin damage.

(5) Pain observation: Pain at the drainage site is often caused by the drainage fluid irritating the surrounding skin, or by the drainage tube pressing the local tissue too tightly, causing secondary infection or migratory abscess. This situation may also cause pain in other parts of the body. Pain at a local fixed point is usually where the lesion is. If severe abdominal pain suddenly subsides, you should highly suspect abscess or organ rupture, and pay attention to changes in the patient's abdominal signs.

(6) The sterile bag should be replaced 2 to 3 times every week. When replacing, attention should be paid to aseptic operation. The drainage tube opening should be disinfected before connecting the drainage bag to avoid retrograde infection.